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Liver transplant outcomes in people with cirrhosis and severe acute-on-chronic liver failure

Observes how liver transplantation works for adults with cirrhosis and acute-on-chronic liver failure.

Key facts

Who runs it
European Foundation for Study of Chronic Liver Failure
Where
Stockholm, SwedenSee the siteAlso in 26 other countries, 104 sites
Trial code
Registry title
Liver Transplantation in Patients With CirrHosis and Severe Acute-on-Chronic Liver Failure: iNdications and outComEs
Status
Recruiting
People taking part
3,000 people, planned
Started
8 Jul 2021
Expected to end
31 Dec 2026
Type of study
Observational, 3 groups
Treatments tested
  • Observational Protocol
Record updated
20 October 2025

Who can take part

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults with liver cirrhosis in hospital for a sudden worsening, referred to the transplant team. It follows people on or assessed for the liver transplant waiting list.

Age
18 Years to 80 Years
Sex
Male or female
Disease stage
Liver cirrhosis with a sudden worsening (acute decompensation). Group 1: listed for liver transplant with ACLF-2 or 3, at listing or while waiting. Group 2: listed with decompensated cirrhosis without ACLF-2 or 3 and MELD>20. Group 3: ACLF-2 or 3, assessed for the waiting list but not listed.
Earlier treatment
Must have been hospitalized for acute decompensation of cirrhosis and referred to the transplant team.
Biomarker or test result
Group 2: MELD score above 20 (a score of liver function) at listing.

The registry criteria, word for word

Show all 5 criteriaShow less

Who can take part

  • 1. Male or female subject ≥18 years of age; Subjects with diagnosis of liver cirrhosis (based on clinical, laboratory, endoscopic, and ultrasonographic features or on histology); Subjects who have been hospitalized for acute decompensation of liver cirrhosis and referred to the transplant team:
  • Group 1: patients listed for liver transplantation with ACLF-2 or 3 at the time of listing or developing ACLF 2-3 while on the waiting list
  • Group 2: patients listed for liver transplantation with decompensated cirrhosis without ACLF-2 or 3 and poor liver function (MELD>20) at the time of listing
  • Group 3: patients having ACLF-2 or 3, are assessed for inclusion in the waiting list, but are finally not listed for liver transplantation; Patients (or trusted person, family member or close relation if the patient is unable to express consent) who have been informed and signed their informed consent Inclusion criteria

Who cannot take part

  • -

Check if you might fit

Answer for yourself. This is not a decision: only the study team can say whether you can take part.

  • Are you between 18 and 80 years old?

Where in Sweden

Also in 26 other countries, 104 sites

  • Karolinska InstitutetStockholm, SwedenContact: Magnus Holmer, PITaking people

About the trial

What the trial wants to find out

Management of ACLF is mainly supportive. The poor outcomes lead physicians to consider liver transplantation as an option, even if controversial. In sicker recipients, LT results in immediate survival, but poor medium-term survival rates in some studies. The scarcity of deceased donors obliges to maximize LT success. Alternative strategies, as living-donor LT, should be explored. LDLT has impressive results in Eastern centers, but it is restrained in Western countries, due to potential life-threatening complications in the donor.

The 3 groups in the trial

  • Group 1

    patients listed for liver transplantation with ACLF-2 or 3 at the time of listing or developing ACLF 2-3 while on the waiting list (n=2,000)

    Treatment: Observational Protocol

  • Group 2

    patients listed for liver transplantation with decompensated cirrhosis without ACLF-2 or 3 and poor liver function (MELD \> 20) at the time of listing (n=500)

    Treatment: Observational Protocol

  • Group 3

    patients having ACLF-2 or 3, are assessed for inclusion in the waiting list, but are finally not listed for liver transplantation (n=500)

    Treatment: Observational Protocol

Questions to ask the study team

  1. How often do I need to come in, and for how long each time?
  2. Are travel costs paid?
  3. Can I keep my own doctor?
  4. What happens if I want to stop?

Contact the study team: see the registry record → Contacts and Locations

Print a page for my doctor

Data and sources

Registry record
Listed on ClinicalTrials.gov.
Official title
Liver Transplantation in Patients With CirrHosis and Severe Acute-on-Chronic Liver Failure (ACLF): iNdications and outComEs
Plain-language title
Liver transplant outcomes in people with cirrhosis and severe acute-on-chronic liver failureGenerated from the registry record. The registry title is the official one.
AI summary
From the trial's eligibility criteria. Read by machine on 14 November 2026.
Fit questions
Built from NCT04613921, who can take part
Publications
Record updated
20 October 2025